How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $42.66 | Facility | None | $33.11 | $33.11 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $87.10 | Professional | None | $33.11 | $35.48 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $28.18 Median $66.07 Typical High $131.83 | Professional | None | $28.18 | $66.07 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $239.88 | Professional | None | $39.81 | $52.48 | $239.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.80 Median $5.25 Typical High $23.99 | Professional | RR · Rental | $3.80 | $5.25 | $23.99 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $39.81 Typical High $177.83 | Professional | UE · Used equipment | $29.51 | $39.81 | $177.83 |
CareSource Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $83.18 | Professional | None | $51.29 | $72.44 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $70.79 | Professional | None | $21.38 | $21.38 | $70.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $309.03 | Professional | None | $52.48 | $52.48 | $309.03 |
Oscar Health Setting Professional Modifier None Typical Low $60.26 Median $69.18 Typical High $74.13 | Professional | None | $60.26 | $69.18 | $74.13 |
United Setting Professional Modifier None Typical Low $16.98 Median $25.70 Typical High $93.33 | Professional | None | $16.98 | $25.70 | $93.33 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $16.22 Typical High $19.05 | Professional | 52 · Reduced service | $15.85 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.61 Typical High $7.59 | Professional | 53 · Discontinued | $6.46 | $6.61 | $7.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $24.55 Typical High $28.18 | Professional | 54 · Surgery only | $23.99 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.90 Typical High $5.75 | Professional | 55 · Aftercare only | $4.79 | $4.90 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.31 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.16 | $3.31 | $3.80 |
Where Georgia sits
The same service costs 2.6 times more in Hawaii than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Georgia· 7th of 51
$50.12
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.